Childbirth – what are your options?

It's a good idea to make a birth plan – a written plan of how your would like to give birth. The plan can be made together with your partner or birthing companion. Find out what your childbirth options are.

Making a birth plan

It's a good idea to make a birth plan – a written plan of how your would like to give birth. The plan can be made together with your partner or birthing companion.

By making a birth plan, you will be making a conscious choice before birth about how you want your labour to be managed, rather than making decisions once labour is underway.

During labour, many women feel distant or even indifferent to what's happening.

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A birth plan can help your partner explain your choices to the medical and midwifery staff.

Below are suggestions of what to include in your birth plan.

Where to give birth?

Think about where you want to give birth.

Depending on the facilities in your area and how your pregnancy is progressing, there are three main choices.

A maternity ward at the hospital

If things change

Your birth plan can only be followed so long as labour is proceeding normally.

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If there are complications, your birth team will discuss these with you, plus what needs to be done to ensure a safe delivery.

They will try to follow your wishes as best they can.

Labour is unpredictable, so it's wise to keep an open mind throughout the birth.

In the UK, by far the most common place to give birth is in the maternity ward of your local hospital. For many women, this is the only sensible option.

Maternity wards have been concentrated in hospitals that have the most up-to-date equipment and well-trained midwives and obstetricians.

Many hospitals realise that their high-tech equipment can be off-putting and impersonal. As such, delivery units are made as relaxed as possible and some offer alternative methods of pain relief such as birthing pools and TENS.

At home

Some women feel that a natural birth is of great importance and want it to take place at home.

If you would prefer a home birth, you can discuss it with either your community midwife or GP.

Far fewer GPs now feel confident they have the necessary skills and availability to support home deliveries.

However, you can arrange care with another GP who does offer this service, if one is available.

You don't have to go through your GP to arrange a home birth – you can contact the local Midwifery Supervisor directly to discuss your options.

A midwife may want to check your home, to ensure it is safe and suitable.

If your pregnancy or labour becomes complicated in any way, you will be encouraged to opt for a hospital delivery.

In a GP/midwife-run unit

Midwife-led units

Midwife-led units can be found within some maternity wards.

They enable women with uncomplicated pregnancies to deliver in less medically-orientated surroundings.

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Such units are usually near the labour ward.

If labour isn't progressing well, transfer to the ward can be made easily.

GP/midwife-run units are widely available in the UK. They are small units where babies can be delivered by a community midwife or a local GP, rather than hospital doctors.

A GP/midwife-run unit will usually have less sophisticated equipment than a major maternity unit, and some can't offer all methods of pain relief.

However, because they are smaller, they tend to feel more personal - the chances are much higher you will be taken care of by someone you already know.

Only women who expect to have a normal delivery will be able to use a GP/midwife-unit.

Sometimes, a GP/midwife-unit can be part of a larger hospital's maternity unit, in which case there will be facilities nearby to cope with an unexpected emergency, should one arise.

What kinds of delivery are available?

The birth options listed below are the ones most commonly used today. If you have any special requests, contact your local maternity ward or talk to a midwife.

Giving birth in a delivery bed

This is an adjustable bed where you can lie down or sit upright according to your needs.

In the past, women disliked this method because they were put flat on their back with their legs up in stirrups. This meant the muscles had to work very hard and you couldn't use gravity to your advantage.

Today, the delivery bed offers a variety of options, although they are not that widely available in the UK. With a modern delivery bed, you can decide how it's adjusted to ensure maximum comfort.

Giving birth in a bean bag chair

This is a chair you can try out in both a lying and sitting position during labour. It has countless small beans inside the bag that support and fit themselves around your body.

If you find it comfortable, and you'd like to use it to give birth, it can simply be placed on the delivery bed. It also gives the midwife a good working posture.

Giving birth in water

Water birth safety

Birthing pools can only be used if there are no complications and the baby doesn't need monitoring.

A water birth also has to be ruled out if certain forms of pain relief are used.

Sitting in warm water makes contractions less painful. It gives you the chance to relax and work with your contractions, instead of against them.

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You can sit or float in a specialised bath, called a birthing pool, once labour is well established.

Whether you can stay in the pool for the delivery itself varies from one maternity ward to the next. You should check with the hospital in advance.

Giving birth by Caesarean

Some women may be advised in advance that a Caesarean section will be needed to deliver their baby.

This is called an elective section and is normally carried out one to two weeks before your baby's due date.

Alternatively, a Caesarean may become necessary if there are complications during labour. This is called an emergency section.

Which delivery position suits you?

Lying on your back

The well-known position of a woman lying flat on her back to give birth remains a common delivery position. However, it can have disadvantages because:

it means using more effort than necessary to lift the upper body when pushing

it prevents the use of gravity to help with the birth.

Kneeling on all fours

Kneeling on all fours in labour has many advantages.

You can rest between contractions and don't need to lift yourself up to push. Gravity works to your advantage and helps your baby settle down in the birth canal.

Sitting upright

Sitting in an upright position is also useful. This way, you don't have to lift yourself up to push; gravity, again, works to your advantage.

However, it can be difficult for the midwife to follow the progress of your labour closely.

As a result, you will sometimes need to adopt the kneeling position for a short time.

Position advice

During labour switch between the positions to whatever suits you best.

However, you are likely to be most active at the start of labour and need more rest towards the end.

Squatting

Squatting can also be used and is a position that has been rediscovered from tribal people.

Squatting is a good position when the time comes to push, but it can put a strain on your knees and back.

For this reason, some maternity wards have small birthing stools.

Alternatively, it may be suggested that your partner supports you under the arms, from behind.

Standing or walking

Standing or walking is an option for the early stages of labour, because it encourages contractions to become regular and stronger.

Some women find it relieves the pain to move around or to lean against their companion.

Although gravity does help the process, standing up to give birth can be extremely tiring.

Music: if you like listening to music, bring your CDs to the maternity ward. Music often has a relaxing, soothing effect.

Movement: moving about during labour can sometimes help to relieve pain.

Massage: discuss it with your partner - a practice session on your loins and lower back is recommended. However, you shouldn't start vigorous massage at the end of your pregnancy without professional guidance.

Warm water: many women enjoy warm showers during labour. The combination of water and warmth makes the muscles relax and helps to ease contractions. It may be possible to use a bath tub or jacuzzi in the local maternity ward. This is an excellent way of relieving pain as well as giving you a chance to work with the contractions.

Other things to include in your birth plan

Here are some other options you need to consider when drawing up your birth plan. Think them through, talk them over with your partner and make your choices.

Would you like your baby on your stomach after he or she is born?

It has become quite common for your newborn baby to be laid on your abdomen immediately after being born. This is to maintain the close bond between mother and child, provide a feeling of security for your baby and help him or her stay warm.

Do you want your partner to cut the cord after the birth?

Many people see cutting the umbilical cord as a symbolic act to separate the mother and baby, and a chance to involve the father as an active participant in the birth of his child.

Are you planning to breastfeed?

You may need help immediately after the birth if you would like to breastfeed your baby. This is often the case if your baby is awake and very alert.

Would you like your partner to photograph or video the birth?

A lot of parents like to have photographs or a video as a memento of the birth.

Before arranging this, your partner or birth companion should make sure you are happy to be filmed, and know how much time to spend on it.

First and foremost, your partner is there to help and support you giving birth.

Do you want students present?

There may be student doctors, nurses and midwives studying in the maternity ward. It's important the next generation of professionals are trained but the presence is can cause some anxiety for some women.

You may be asked to give consent for a student to be involved in your delivery. It's your choice whether to give your consent for their presence during the delivery of your baby.

Although this is part of their training, if you don't feel comfortable about having them there, or it's not in accordance with your culture, it's important to say so.

The materials in this web site are in no way intended to replace the professional medical care, advice, diagnosis or treatment of a doctor. The web site does not have answers to all problems. Answers to specific problems may not apply to everyone. If you notice medical symptoms or feel ill, you should consult your doctor - for further information see our Terms and conditions.